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Home My WebLink AboutDalecki, PaulELIZABETH A. NEVILLE, MMC TOWN CLERK REGISTRAR, OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Sabrina Born, Southold Town Clerk's Office DATED: July 7, 2015 RE: Cesspool Construction Application Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 www.southoldtownny.gov JUL - 8 2015 1 Transmitted herewith is a copy of application No. 4328 for a Cesspool/Septic Tank Construction Permit submitted by: Almas Construction LLC for Paul & Mary Daleeki Please review the application and location map and advise if this office may issue the permit. Please complete the form below and return it to me. Thank you. I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE DISAPPROVE Comments: Final approval required from the Suffolk County Health Department osla hs Dated OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION 14"", CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.northfork.net u as 73.40 Residential @ $10 Non -Residential $25 Application No. Permit No: l C� LG c Applicant Name Applicant Mailing Address Septic Tank mor Cesspool Brief Description of Proposed Construction or Alteration e--� LA --e- f I t Location of Proposed Construction/Alteration: Owner of Property; j Owner Mailing .-SK-, " Owner Property Address 5. /v Name and phone number of contact person Tax Map No: Section ?, Z_ Block Lot Cross Street NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WIIH-U&ALI - EPARTMENT APPROVAL Signature of A??ricaM'Dad -- ReceiVed by: tart ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS OFFICER MARRIAGE RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION 14"", CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.northfork.net u as 73.40 Residential @ $10 Non -Residential $25 Application No. Permit No: l C� LG c Applicant Name Applicant Mailing Address Septic Tank mor Cesspool Brief Description of Proposed Construction or Alteration e--� LA --e- f I t Location of Proposed Construction/Alteration: Owner of Property; j Owner Mailing .-SK-, " Owner Property Address 5. /v Name and phone number of contact person Tax Map No: Section ?, Z_ Block Lot Cross Street NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WIIH-U&ALI - EPARTMENT APPROVAL Signature of A??ricaM'Dad -- ReceiVed by: LOT AREA = 20,390 SQ. FT. PROPOSED 2 STY FR DWELLING = 3,406 SQ. FT. W/3 BEDROMS SANITARY SYSTEM 1000 GALLON SEPTIC TANK, 1 LEACHING POOL 8' DIA. 02' GAR FL. ELEV = 36 5 ( ) ELEVATIONS F FL ELEV = 38.5 NOTE DATUM N.A.V.D 1988 VACANT _, j jjj��~ VACANT LOT NUMBER 14 FD MON a 5 7'N N 79"4240"E z (37 7) N C7 prop c''_ screen (36.5) DWELL room 11 7 — 39.0' (36.5) well covered porch to PROP II s, 0 2 FSTY R I` DWELL m 150' x 6 1" 390, Cl 90 L4 S to prop deck (36.5) S Cn O 5FD MON 3.5'N 6 1 S 79°42'40" DWELL./WELL well greater than 150to property TEST HOLE by McDONALD GEOSCIENCE 5-15-2015 0' __ DARK BROWN LOAM OL 150' / 173.50' (35.7)FD prop MON we11 (34 1) 150' 29.7' R v 45' 26.0' I v N O 146 — (36.5) 00 TEST HOLE p prop O pole ��_ driveway l {0 13 5.34.4 (33.8) ° 1 09' FD MON (held) LOT NUMBER 1 N c� 0 O WILLOW DRIVE 150' SUFFOLK COUNTY DEPARTMENT OF HEALTH S}.-mcCG MrAtT FOR APPROVAL OF CCNSiP.ucTj }rd FOR A SINGLE FAMILY RESIDENCE ONLY 2 741 -T 003 j APPRovev 1, F61t=1MUt4 OF SEMAPPROVAL U-PIRES THREE YEARS FR m DATE BROWN SILTY SAND SM ! /OOFF W`Weetl I we ff -ani 1 a r est 7 � -C p/ re, I� BROWN FINE TO COARSE SAND SW I THE OFFSETS (OR CIMENMONS) SH9.1!N !ir'3'Ei ON FROM THE STRUCTURES TO Ta PROi'ERTY LINES ARE FOR A SPECIFIC PURPOSE A;:D USE AND THEREFORE kiE NOT INTENDED TO GUIDE THE ERECTION OF FENC9. RETAINING WAILS, POOLS. PATIOS. NO WATER ENCOUNTERED PL&VTIAG AREAS, ADDITION TO BUILDINGS OR ANY OTHER CONSTRUCTION. UNAUTHORIZED ALTERATION OR AMMON TO THIS SURVEY IS A VIOLATION OF SECTION 72DO OF THE NEW YORK STATE EDUCATION LAW. GUARA14TEES INDICATED HEREON SIiALL RUN ONLY TO THE PERSON FOR WNUM THE SUR%TY IS PREPARED, AND ON KIS. BSHA1F TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO TILE ASSIGNEES OF THE LEKM14G INSTTIUAO:i, GU.4R&IME a ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS NOT E: OR SUBSEQUENT OWNERS. Location of water mains COPIES OF THIS SURVEY ASAP NOT BEARING TRE LAND SURVEYOR'S INKED SEAL OR & adjoiners water supply EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. by others and ore not guaranteed I CERTIFIED ONLY TO: 1111 ..•. � �; :i.d/ �'AyZ92015 DWELL well 02> 1 / HAROLD F N Y L TRANCHON JR. PENN. lo. 048992 No. 2115=E lex DWELL well 02> 1 L ILIr.; lex DWELL J well T o U 7 T 8 5 A Ty��s DWELL well DWELL JOB No 15-61 FILE No STARS MANOR SURVEYED FOR LOT NUMBER 13 MAP OF STARS MANOR SITUATED AT EAST MARION TOWN OF SOUTHOLD, SUFFOLK COUNTY, N.Y SCALE 1" = 40' DATE 5-6-2015 FILED MAP No. 3864 DATE 10-19-1963 TAX MAP Na. (REF ONLY) 1000-22-4-9 - DISK 2015 HAROLD F. TRANCHON JR. P.C. LAND SURVEYOR P.O. BOX 616 1866 WADING RIVER—MANOR RD. WADING RIVER, NEW YORK, 11792 631-929-4695 7 L DWELL J well T o U 7 T 8 DWELL JOB No 15-61 FILE No STARS MANOR SURVEYED FOR LOT NUMBER 13 MAP OF STARS MANOR SITUATED AT EAST MARION TOWN OF SOUTHOLD, SUFFOLK COUNTY, N.Y SCALE 1" = 40' DATE 5-6-2015 FILED MAP No. 3864 DATE 10-19-1963 TAX MAP Na. (REF ONLY) 1000-22-4-9 - DISK 2015 HAROLD F. TRANCHON JR. P.C. LAND SURVEYOR P.O. BOX 616 1866 WADING RIVER—MANOR RD. WADING RIVER, NEW YORK, 11792 631-929-4695 7